I leak urine…. is that normal?

In my daily interactions with women of all age groups the vast majority has heard the statement “I laughed so hard I peed my pants” at least a handful of times. This problem is called stress urinary incontinence (SUI) and though benign it results in poor quality of life for women. About 1 out of 3 women over the age of 45 experience urine leakage when they walk, laugh, cough or perform exercises however, only 50% seek treatment.

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Why do I leak urine when I laugh or cough? 

SUI may be caused by weakened pelvic floor muscles or injury to the genitourinary system. The onset of urinary leakage during and after pregnancy often feeds into the misconception that this problem is just a normal part of childbearing. Furthermore, embarrassment and lack of awareness regarding treatment often leads to a failure to seek care. SUI is a common problem, but it is not a normal part of aging or childbirth. 

Evaluation for urine leakage

During the initial evaluation for urine leakage, you will be asked to complete a questionnaire and bladder diary that helps clarify the type and severity of your urinary leakage problem. During your exam, a urine test is performed to check for bladder infections. We will also check how well your bladder empties. A pelvic exam is also performed to evaluate your pelvic floor muscle strength, the positioning of your pelvic organs and evaluate for other gynecologic problems. Though your evaluation may feel awkward it is not usually painful. 

Treatment for urine leakage

Treatment of stress urinary incontinence involves the use of many different approaches. Some basic interventions that you can try include: reduction of the amount of fluid you drink, pelvic floor muscle exercises, weight loss, vaginal tampons and even quitting smoking may help.  When basic interventions fail your doctor may recommend a surgical procedure. 

When is it time to seek treatment for urine leakage?

It may be time for an evaluation if you: 

  • Experience daily bladder leakage
  • Are afraid to perform certain activities like exercise
  • Restrict fluid for fear of bladder leakage
  • Avoid social situations due to bladder leakage


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